Author Topic: When will a vaccine *really* be available?  (Read 56754 times)

Offline yoshapman

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Re: When will a vaccine *really* be available?
« Reply #100 on: January 29, 2021, 10:14:44 AM »
What does it hurt to submit a new form now?

Wasn't sure if there's an issue with doing that.

Offline ShimshonK

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Re: When will a vaccine *really* be available?
« Reply #101 on: February 11, 2021, 06:11:21 PM »

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Re: When will a vaccine *really* be available?
« Reply #102 on: February 15, 2021, 01:02:04 AM »
Not sure where the best thread for this question is, so please direct me elsewhere if better.

Has there been any science and studies regarding the immunity from vaccine antibodies?
I got the first dose of the vaccine, and then tested positive for antibodies 2 weeks later (did not receive any numbers, just positive for IgG). I'd like to know what information is out there on this topic, and if it's fair to presume immunity at this point (I will still get the second dose - just interested to know level of covid concerns and precautions I should be taking).

It also seems to be unclear if the traditional antibody tests are supposed to be accurate for vaccine antibodies. I saw a note from one testing site (not where I tested) that wrote "NOTE: At the current time, our antibody test is only able to test for antibodies from an actual covid-19 infection. It is not able to test for antibodies from a vaccine (spike protein). We anticipate having this available in the next few weeks."

@S209 @biobook

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Re: When will a vaccine *really* be available?
« Reply #103 on: February 15, 2021, 01:07:31 AM »
Not sure where the best thread for this question is, so please direct me elsewhere if better.

Has there been any science and studies regarding the immunity from vaccine antibodies?
I got the first dose of the vaccine, and then tested positive for antibodies 2 weeks later (did not receive any numbers, just positive for IgG). I'd like to know what information is out there on this topic, and if it's fair to presume immunity at this point (I will still get the second dose - just interested to know level of covid concerns and precautions I should be taking).

It also seems to be unclear if the traditional antibody tests are supposed to be accurate for vaccine antibodies. I saw a note from one testing site (not where I tested) that wrote "NOTE: At the current time, our antibody test is only able to test for antibodies from an actual covid-19 infection. It is not able to test for antibodies from a vaccine (spike protein). We anticipate having this available in the next few weeks."

@S209 @biobook
One more question I have is regarding the possibility that's been discussed of vaccinated people still getting and transmitting the disease, just without getting sick. Though, if that was presumed to be a real possibility, how would the CDC make an exemption for recently vaccinated people to not quarantine after an exposure??

Offline S209

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Re: When will a vaccine *really* be available?
« Reply #104 on: February 15, 2021, 01:07:35 AM »
@S209 @biobook
To include both posters mentioned, I’ll reply with an earlier quote from @biobook
Yes, that's exactly right. 
If you DO have antibodies after the vaccine, it's still possible that your antibody levels are too low and you ARE NOT immune. 
If you DON'T have antibodies after the vaccine, it's still possible that your T cells are now high enough that you ARE immune.

(I assume you mean a few days after the second vaccine, since it would take a while to get high antibodies after the first.)
 
It is possible that in some people the vaccine "works" to produce antibodies, but doesn't "work" to confer immunity.  But you're not entering a contest to see who gets the most antibodies; (semicolon!) you want immunity.  The experts are still not sure what exact value for antibodies/T cells corresponds to immunity. 
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Offline S209

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Re: When will a vaccine *really* be available?
« Reply #105 on: February 15, 2021, 01:19:47 AM »
One more question I have is regarding the possibility that's been discussed of vaccinated people still getting and transmitting the disease, just without getting sick. Though, if that was presumed to be a real possibility, how would the CDC make an exemption for recently vaccinated people to not quarantine after an exposure??
It is now established that people who have been vaccinated are less likely to:
1) Test positive for COVID (based on data out of Israel and asymptomatic patients in the Pfizer/Moderna trials who were tested before their second dose)
2) Develop symptomatic COVID
3) Develop severe COVID
It’s also likely (but mostly speculative) that even those vaccinated patients who do contract COVID are less likely to spread it (based on observed lower viral loads in Israel, and a general correlation between symptomatic COVID and contagion). Remember, transmission from patients who *remain* asymptomatic (like the majority of vaccinated COVID+) is relatively rare.

These factors may play a role in the CDCs guidance. They might also just be trying to incentivize vaccination..
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Re: When will a vaccine *really* be available?
« Reply #106 on: February 15, 2021, 01:22:52 AM »
Not sure where the best thread for this question is, so please direct me elsewhere if better.

Has there been any science and studies regarding the immunity from vaccine antibodies?
I got the first dose of the vaccine, and then tested positive for antibodies 2 weeks later (did not receive any numbers, just positive for IgG). I'd like to know what information is out there on this topic, and if it's fair to presume immunity at this point (I will still get the second dose - just interested to know level of covid concerns and precautions I should be taking).

It also seems to be unclear if the traditional antibody tests are supposed to be accurate for vaccine antibodies. I saw a note from one testing site (not where I tested) that wrote "NOTE: At the current time, our antibody test is only able to test for antibodies from an actual covid-19 infection. It is not able to test for antibodies from a vaccine (spike protein). We anticipate having this available in the next few weeks."

@S209 @biobook
In short you can’t assume immunity. You can see a thorough explanation from @biobook somewhere recent. Basically, antibodies alone don’t necessarily confer immunity, there are other parts like T Cells etc.

It’s well documented that even ppl who have antibodies at 14 days after dose 1 aren’t as immune as those who got the second dose. Figure around 50% efficient compared to 95-100%
״וזה כלל גדול: שישנא אדם כל דבר שקר. וכל מה שיוסיף שנאה לדרכי השקר – יוסיף אהבה לתורה.״ - אורחות צדיקים

Offline S209

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Re: When will a vaccine *really* be available?
« Reply #107 on: February 15, 2021, 01:34:53 AM »
In short you can’t assume immunity. You can see a thorough explanation from @biobook somewhere recent. Basically, antibodies alone don’t necessarily confer immunity, there are other parts like T Cells etc.

It’s well documented that even ppl who have antibodies at 14 days after dose 1 aren’t as immune as those who got the second dose.
A friend of mine tested positive last week for COVID after being exposed 17 days after his first dose. He had a very low fever (below 100).

Figure around 50% efficient compared to 95-100%

Where did you get these numbers from? AFAIK from day 14-28 in the Moderna trial (small sample size) the vaccine was close to 90% effective against symptomatic illness.
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Re: When will a vaccine *really* be available?
« Reply #108 on: February 15, 2021, 02:50:30 AM »
https://twitter.com/erlichya/status/1361217556619616256

Apparently Klalit, Maccabe, and Eran Segal are using very different methods when discussing the Israeli vaccine efficacy.

Where did you get these numbers from? AFAIK from day 14-28 in the Moderna trial (small sample size) the vaccine was close to 90% effective against symptomatic illness.
Israel. I could be wrong, but I seem to remember their results were closer to 50% on day 14-21 for Pfizer (which would suggest the Moderna studies don’t perfectly reflect real world data either)
״וזה כלל גדול: שישנא אדם כל דבר שקר. וכל מה שיוסיף שנאה לדרכי השקר – יוסיף אהבה לתורה.״ - אורחות צדיקים

Offline S209

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Re: When will a vaccine *really* be available?
« Reply #109 on: February 15, 2021, 10:03:55 AM »
Israel. I could be wrong, but I seem to remember their results were closer to 50% on day 14-21 for Pfizer (which would suggest the Moderna studies don’t perfectly reflect real world data either)
IINM you are referring to positive tests, not symptomatic illness.
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Offline ShimshonK

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Re: When will a vaccine *really* be available?
« Reply #110 on: February 15, 2021, 10:12:31 AM »
To include both posters mentioned, I’ll reply with an earlier quote from @biobook
In short you can’t assume immunity. You can see a thorough explanation from @biobook somewhere recent. Basically, antibodies alone don’t necessarily confer immunity, there are other parts like T Cells etc.

It’s well documented that even ppl who have antibodies at 14 days after dose 1 aren’t as immune as those who got the second dose. Figure around 50% efficient compared to 95-100%
Would you consider it the same immune as someone who has a positive antibody test from COVID? Because, IINM, there's a pretty high chance there of immunity.
I understand it's not 100%, even the full vaccine regimen doesn't make it 100%, but I'm curious to know the likelihood of immunity.

Offline biobook

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Re: When will a vaccine *really* be available?
« Reply #111 on: February 15, 2021, 10:43:28 AM »

Has there been any science and studies regarding the immunity from vaccine antibodies?
I got the first dose of the vaccine, and then tested positive for antibodies 2 weeks later (did not receive any numbers, just positive for IgG). I'd like to know what information is out there on this topic, and if it's fair to presume immunity at this point (I will still get the second dose - just interested to know level of covid concerns and precautions I should be taking).
@ShimshonK +1 to answers you've gotten already. 
You should assume you are not at all immune and should continue to take all precautions until two weeks after the second dose. 

Pfizer's clinical trials showed that people receiving vaccine and placebo got infected at the exact same rate during the first two weeks after injection.  It was only around day 12 or so that the vaccinated group showed an obviously lower rate of infection.  The scientific reason for this time lag is that biological processes require time - time for the mRNA to produce spike protein, time for the T cells to signal B cells to reproduce, time for those B cells to churn out antibodies, etc.  [/quote]

Quote
It also seems to be unclear if the traditional antibody tests are supposed to be accurate for vaccine antibodies. I saw a note from one testing site (not where I tested) that wrote "NOTE: At the current time, our antibody test is only able to test for antibodies from an actual covid-19 infection. It is not able to test for antibodies from a vaccine (spike protein). We anticipate having this available in the next few weeks."
If you took an antibody test before the vaccine, and it showed you didn't have antibodies at that time, then the positive response you got two weeks after the vaccine was probably due to the vaccine.  But nobody knows what level of antibodies is sufficient for immunity, so you shouldn't use the positive test as relevant to the decision re: precautions.

If you didn't take an antibody test before the vaccine, then it's possible you had an asymptomatic infection, in which case the post-vaccine antibodies could have been produced either in response to the infection or to the vaccine.

The virus contains Spike and Nucleocapsid proteins, so someone with a natural infection would have antibodies to S and N.  Some antibody tests measured S and some N.  The vaccine induces antibodies to S only.  So the sign was in effect telling people that the test in that clinic was measuring N, so a positive test would mean you'd been infected, but couldn't tell you if you've got antibodies to S, which would mean EITHER that you got infected or that you were vaccinated.

Offline ShimshonK

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Re: When will a vaccine *really* be available?
« Reply #112 on: February 15, 2021, 10:58:54 AM »
@ShimshonK +1 to answers you've gotten already. 
You should assume you are not at all immune and should continue to take all precautions until two weeks after the second dose. 

Pfizer's clinical trials showed that people receiving vaccine and placebo got infected at the exact same rate during the first two weeks after injection.  It was only around day 12 or so that the vaccinated group showed an obviously lower rate of infection.  The scientific reason for this time lag is that biological processes require time - time for the mRNA to produce spike protein, time for the T cells to signal B cells to reproduce, time for those B cells to churn out antibodies, etc. 
If you took an antibody test before the vaccine, and it showed you didn't have antibodies at that time, then the positive response you got two weeks after the vaccine was probably due to the vaccine.  But nobody knows what level of antibodies is sufficient for immunity, so you shouldn't use the positive test as relevant to the decision re: precautions.

If you didn't take an antibody test before the vaccine, then it's possible you had an asymptomatic infection, in which case the post-vaccine antibodies could have been produced either in response to the infection or to the vaccine.

The virus contains Spike and Nucleocapsid proteins, so someone with a natural infection would have antibodies to S and N.  Some antibody tests measured S and some N.  The vaccine induces antibodies to S only.  So the sign was in effect telling people that the test in that clinic was measuring N, so a positive test would mean you'd been infected, but couldn't tell you if you've got antibodies to S, which would mean EITHER that you got infected or that you were vaccinated.
Thank you for all that info. I did have a negative antibody test a couple weeks before the vaccine was taken. And, while I did have a household covid exposure during that month time-frame, we separated completely, and I got tested multiple times throughout (all negative), so I'm fairly sure these antibodies are from the vaccine.
Would you consider this the same level of immunity as anyone who had antibodies from covid itself, or you'd think this is less? I know in some cities, right or wrong, the schools and other local establishments consider covid antibodies to be a good level of immunity and thus have different policies for those individuals upon exposures, etc.
I may try to test again somewhere that provides the numbers, as maybe that will be helpful.
Lastly, will I begin to gain that added second dose protection within 3 days of receiving it? (Curious because my scheduled shot is Monday before Purim).

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Re: When will a vaccine *really* be available?
« Reply #113 on: February 15, 2021, 11:43:31 AM »
One more question I have is regarding the possibility that's been discussed of vaccinated people still getting and transmitting the disease, just without getting sick. Though, if that was presumed to be a real possibility, how would the CDC make an exemption for recently vaccinated people to not quarantine after an exposure??
A small percentage of vaccinated people do get sick and therefore can transmit the virus.  The vaccinated people who don't get sick might still get infected and transmit the virus to others. That is still a possibility, that is, scientists just don't know yet whether it will occur to a significant degree. 

That's the science.  But the CDC integrates the science with the needs of society and with considerations of human behavior.  So they've concluded that the potential risk that a vaccinated person will transmit the virus seems to be lower than the known social problems caused by a 14 day quarantine.  So on balance, quarantine is no longer required. 

This new advice is that a vaccinated person doesn't need to quarantine after exposure to a covid-positive person IF
  • it's at least two weeks after the second vaccine
  • it's within 3 months after the second vaccine
  • the vaccinated person isn't showing symptoms
The vaccinated person should be carefully monitoring, though, and if they do start showing any symptoms they should quarantine.
In addition, even though the vaccinated person doesn't need to quarantine, they should continue to follow the other public health recommendations: to mask, socially distance, wash hands, avoid crowded and indoor settings.

Offline biobook

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Re: When will a vaccine *really* be available?
« Reply #114 on: February 15, 2021, 12:30:22 PM »
Thank you for all that info. I did have a negative antibody test a couple weeks before the vaccine was taken. And, while I did have a household covid exposure during that month time-frame, we separated completely, and I got tested multiple times throughout (all negative), so I'm fairly sure these antibodies are from the vaccine.
Would you consider this the same level of immunity as anyone who had antibodies from covid itself, or you'd think this is less? I know in some cities, right or wrong, the schools and other local establishments consider covid antibodies to be a good level of immunity and thus have different policies for those individuals upon exposures, etc.
I may try to test again somewhere that provides the numbers, as maybe that will be helpful.
Lastly, will I begin to gain that added second dose protection within 3 days of receiving it? (Curious because my scheduled shot is Monday before Purim).
Shimshon, you're asking intelligent questions, so you've probably been following the news on covid for a while already, and you know that as our knowledge about the virus evolves, the public health guidance also changes.  I'm not sure that the same can be said for those establishments that devise policy based on antibody levels.  Although that was considered a possibility back in May? June? I can't remember exactly when.  But since then, public health advice is that the value of measuring antibody level is that it helps a physician decide how to treat a patient's current symptoms, and that it shouldn't be used to draw conclusions about a person's immunity to the virus.  So there's no reason for you to test again.

With someone who has covid, antibodies also are produced after a time lag after infection. 
"Most persons infected with SARS-CoV-2 display an antibody response between day 10 and day 21 after infection. Detection in mild cases can take longer time (four weeks or more) and in a small number of cases antibodies (i.e., IgM, IgG) are not detected at all (at least during the studies’ time scale)."
https://www.ecdc.europa.eu/en/covid-19/latest-evidence/immune-responses

So the fact that you developed antibody two weeks after injection is similar to what happens in natural covid infection (and in any infection, and after any vaccination).  But two important points:  The quote above refers to detection of antibodies, not elevation of antibodies to a level high enough to fight infection.  We just don't know yet if there's some threshold of antibodies needed to fight infection.  And there is a large range in response (as little as 10 days, as much as 21 days in different people). 

This variation is important to keep in mind when you think about your own individual immunity.  Clinical trials look at tens of thousands of people, and the results they give tell us what will happen with the average human.  But because of the variation in how individuals respond, they can't tell us anything about any one particular person.  For example, it's possible that you're a bit faster than average in developing an antibody response, but a bit slower than average in developing a T cell response, and both are needed for complete immunity.  It's just not meaningful to try to calculate your own level of immunity based on antibody level at this time.

Compare it to this: We know that about 15% of smokers get lung cancer.  That refers to smokers as a group.  But we can't generally predict for one individual smoker whether they'll fall into the 15% who do or the 85% who don't get lung cancer. 

Re: Purim:  You should definitely be marbim b'simcha, but with a mask on, socially distancing, etc.  The mask at least is appropriate for Purim anyway.  You should assume that you don't have complete immunity until 2 weeks after the second dose. 

This is not to say that you won't have complete immunity, because remember there's a lot of variation in how individual people respond to the vaccine and to the virus.  Immunity probably increases over the entire time interval, so it's not as if it's zero all along, and then bam!  2 weeks post-vaccination it goes up to 95%.  So your chances of getting infected one week after the second vaccine is probably very very low.   But the recommendation is based on the study of large groups of people, and how likely they were to get infected, and that seems to reach a low plateau 2 weeks post-vaccine.

A second reason for maintaining precautions at that time is because .... imagine taking all these precautions, going through two vaccines, and then punkt! you come down with covid.  The irony would be too much to bear...  :-\

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Re: When will a vaccine *really* be available?
« Reply #115 on: February 15, 2021, 01:12:20 PM »
And, while I did have a household covid exposure during that month time-frame, we separated completely, and I got tested multiple times throughout (all negative)

Just want to point out, infection has been known to spread via air and plumbing, so it's hard to be sure of that.

A negative test tells you nothing, its' probably possible for somebody to test negative every 10 minutes throughout an infection because the virus simply didn't make it on to the samples, but still develop antibodies (although they were probably never contagious).

I believe there are documented cases of people who tested negative repeatedly but still were diagnosed with Covid based on lung CTs and biopsies.
״וזה כלל גדול: שישנא אדם כל דבר שקר. וכל מה שיוסיף שנאה לדרכי השקר – יוסיף אהבה לתורה.״ - אורחות צדיקים

Offline ShimshonK

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Re: When will a vaccine *really* be available?
« Reply #116 on: February 15, 2021, 01:19:26 PM »
Shimshon, you're asking intelligent questions, so you've probably been following the news on covid for a while already, and you know that as our knowledge about the virus evolves, the public health guidance also changes.  I'm not sure that the same can be said for those establishments that devise policy based on antibody levels.  Although that was considered a possibility back in May? June? I can't remember exactly when.  But since then, public health advice is that the value of measuring antibody level is that it helps a physician decide how to treat a patient's current symptoms, and that it shouldn't be used to draw conclusions about a person's immunity to the virus.  So there's no reason for you to test again.

With someone who has covid, antibodies also are produced after a time lag after infection. 
"Most persons infected with SARS-CoV-2 display an antibody response between day 10 and day 21 after infection. Detection in mild cases can take longer time (four weeks or more) and in a small number of cases antibodies (i.e., IgM, IgG) are not detected at all (at least during the studies’ time scale)."
https://www.ecdc.europa.eu/en/covid-19/latest-evidence/immune-responses

So the fact that you developed antibody two weeks after injection is similar to what happens in natural covid infection (and in any infection, and after any vaccination).  But two important points:  The quote above refers to detection of antibodies, not elevation of antibodies to a level high enough to fight infection.  We just don't know yet if there's some threshold of antibodies needed to fight infection.  And there is a large range in response (as little as 10 days, as much as 21 days in different people). 

This variation is important to keep in mind when you think about your own individual immunity.  Clinical trials look at tens of thousands of people, and the results they give tell us what will happen with the average human.  But because of the variation in how individuals respond, they can't tell us anything about any one particular person.  For example, it's possible that you're a bit faster than average in developing an antibody response, but a bit slower than average in developing a T cell response, and both are needed for complete immunity.  It's just not meaningful to try to calculate your own level of immunity based on antibody level at this time.

Compare it to this: We know that about 15% of smokers get lung cancer.  That refers to smokers as a group.  But we can't generally predict for one individual smoker whether they'll fall into the 15% who do or the 85% who don't get lung cancer. 

Re: Purim:  You should definitely be marbim b'simcha, but with a mask on, socially distancing, etc.  The mask at least is appropriate for Purim anyway.  You should assume that you don't have complete immunity until 2 weeks after the second dose. 

This is not to say that you won't have complete immunity, because remember there's a lot of variation in how individual people respond to the vaccine and to the virus.  Immunity probably increases over the entire time interval, so it's not as if it's zero all along, and then bam!  2 weeks post-vaccination it goes up to 95%.  So your chances of getting infected one week after the second vaccine is probably very very low.   But the recommendation is based on the study of large groups of people, and how likely they were to get infected, and that seems to reach a low plateau 2 weeks post-vaccine.

A second reason for maintaining precautions at that time is because .... imagine taking all these precautions, going through two vaccines, and then punkt! you come down with covid.  The irony would be too much to bear...  :-\
Thank you for the detailed breakdown!
To take it back a step, because I have not been following as closely as you :)
1. Has positive antibody correlation tied to immunity been totally debunked?
2. Is it fair to assume the vaccine antibodies are equivalent to covid antibodies, in terms of immunity likelihood?

Even if something isn't completely proven, I think it's understandable for it to be taken into account if there's a high likelihood of correlation. An example would be the vaccine itself. You write "You should assume that you don't have complete immunity until 2 weeks after the second dose." If we were to only trust 100% proven data, we would not assume immunity even 2 weeks after the second dose, as it's only shown a 95% likelihood of immunity.
I've been taking all of the precautions all along, and I plan to, at least somewhat, through Purim - but I still feel that knowing the odds that I'm immune will help me to know just how concerned I should be.

Offline ShimshonK

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Re: When will a vaccine *really* be available?
« Reply #117 on: February 15, 2021, 01:21:59 PM »
Just want to point out, infection has been known to spread via air and plumbing, so it's hard to be sure of that.

A negative test tells you nothing, its' probably possible for somebody to test negative every 10 minutes throughout an infection because the virus simply didn't make it on to the samples, but still develop antibodies (although they were probably never contagious).

I believe there are documented cases of people who tested negative repeatedly but still were diagnosed with Covid based on lung CTs and biopsies.
Ya, I understand it to be possible, I just am assuming it was from the vaccine based on those circumstances.
I guess if I really wanted to know, I could get an antibody test that tests for Nucleocapsid proteins.
 
The virus contains Spike and Nucleocapsid proteins, so someone with a natural infection would have antibodies to S and N.  Some antibody tests measured S and some N.  The vaccine induces antibodies to S only.  So the sign was in effect telling people that the test in that clinic was measuring N, so a positive test would mean you'd been infected, but couldn't tell you if you've got antibodies to S, which would mean EITHER that you got infected or that you were vaccinated.
« Last Edit: February 15, 2021, 01:26:50 PM by ShimshonK »

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Re: When will a vaccine *really* be available?
« Reply #118 on: February 15, 2021, 01:22:15 PM »

1. Has positive antibody correlation tied to immunity been totally debunked?
Yes, virtually everybody in the vaccine trials presented antibodies 2 weeks after dose 1, yet not all of them had immunity or any correlation to blood antibodies levels.

I posted the data elsewhere. 
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Re: When will a vaccine *really* be available?
« Reply #119 on: February 15, 2021, 01:24:48 PM »
Yes, virtually everybody in the vaccine trials presented antibodies 2 weeks after dose 1, yet not all of them had immunity or any correlation to blood antibodies levels.

I posted the data elsewhere. 

I think he's asking if we have any confirmed infections of people with confirmed high antibody levels at the time of the infection. And I think the answer is no.
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